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The contemporary epidemics of opioid abuse and overdose demand effective outpatient treatment options. Intramuscular extended-release (XR) naltrexone (an opiate antagonist) offers one option, but guidelines recommend 7 to 10 days of abstention from opiates beforehand to prevent precipitated withdrawal. This abstention period has proven problematic, and relapse rates have been high. These researchers compared the standard buprenorphine induction strategy before XR-naltrexone injection with a detoxification protocol assisted with oral naltrexone.
The 150 opiate-dependent adults were openly randomized in a 2:1 ratio to the protocols (mean age, 35; women, 14%; white, 64%); 37% primarily used prescription opioids (rather than heroin). Naltrexone-…